POST OP CARE.pptx surgery presentation ppt

Post operative care

1. POSTOP CARE

2. Thyroidectomy Initial dressing changed after 48-72 hours (to inspect for infection of suture line),Unless there is soakage, when it should be removed earlier. Dry dressings sufficient every alternate day, if suture line is clean and dry. Sutures usually removed on 5th post- operative day.- This gives minimum scarring.

3. Laryngeal nerve damage • Assess the ability to speak aloud, tone of voice. • location of laryngeal nerve increases the risk of damage during the surgery • Hoarseness may due to oedema or endotracheal tube used in the surgery -will subside .If permanent loss of vocal volume is potential danger

4. Respiratory distress Assess respiratory rate, rhythm, depth and effort.Humidification as needed • Assist with coughing deep breathing • Have suction equipment,oxygen tracheostomy set available• As a result from haemorrhage and oedema may compress the trachea

5. Haemorrhage • Assess dressing & area under the patient's neck and shoulder for drainage • Monitor BP,Pulse for hypovolemic shockAssess the tightness of the dressing • Vascularity of the gland increases risk of haemorrhage• Grater in first 12-24 hrs after surgery

6. Tetany •• Assess for calcium deficiency •Including tingling of toes, fingers & lipa •Keep ca gluconate or ca chloride available for IV useAs parathyroid glands are near to thyroid gland,during the surgery it can injure or remove resulting hypocalcemia and tetany •Occur in 1-7 days after surgery

7. Hypocalcemia Trousseau's Sign •Induction of carpopedal spasm by inflation of a sphygmo above SBP for 3 minutes •Response: Carpopedal spasm characterized by Adduction of the thumb. Flexion of the metacarpophalangeal joints• Extension of the interphalangeal joints Flexion of the wrist

8. The Chvostek sign (also Weiss sign) is one of the signs of tetany seen in hypocalcemia It refers to an abnormal reaction to the stimulation of the facial nerve.When the facial nerve is tapped at the angle of the jaw (i.e. masseter muscle), the facial muscles on the same side of the face will contract momentarily due hyperexcitability of nerves.

9. THANK YOU